You are under considerable stress since your doctor knows NOTHING about
getting you to 100% recovery. Is that stress contributing to your CVD risk? A very simple question for your doctor to answer, not dodge
the question.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=171455&CultureCode=en
Heightened activity in the amygdala - a region of the brain involved
in stress - is associated with a greater risk of heart disease and
stroke, according to a study published in The Lancet that provides new
insights into the possible mechanism by which stress can lead to
cardiovascular disease in humans.
While more research and larger
studies are needed to confirm the mechanism, the researchers suggest
that these findings could eventually lead to new ways to target and
treat stress-related cardiovascular risk.
Smoking, high blood
pressure and diabetes are well-known risk factors for cardiovascular
disease and chronic psychosocial stress could also be a risk factor.
Previously,
animal studies identified a link between stress and higher activity in
the bone marrow and arteries, but it has remained unclear whether this
also applies to humans. Other research has also shown that the amygdala
is more active in people with post-traumatic stress disorder (PTSD),
anxiety and depression, but before this study no research had identified
the region of the brain that links stress to the risk of heart attack
and stroke.
In this study, 293 patients were given a combined
PET/CT scan to record their brain, bone marrow and spleen activity and
inflammation of their arteries. The patients were then tracked for an
average of 3.7 years to see if they developed cardiovascular disease. In
this time 22 patients had cardiovascular events including heart attack,
angina, heart failure, stroke and peripheral arterial disease.
Those
with higher amygdala activity had a greater risk of subsequent
cardiovascular disease and developed problems sooner than those with
lower activity.
The researchers also found that the heightened
activity in the amygdala was linked to increased bone marrow activity
and inflammation in the arteries, and suggest that this may cause the
increased cardiovascular risk. The authors suggest a possible biological
mechanism, whereby the amygdala signals to the bone marrow to produce
extra white blood cells, which in turn act on the arteries causing them
to develop plaques and become inflamed, which can cause heart attack and
stroke.
In a small sub-study, 13 patients who had a history of
PTSD also had their stress levels assessed by a psychologist, underwent a
PET scan and had their levels of C-reactive protein - a protein that
indicates levels of inflammation in the body - measured. Those who
reported the highest levels of stress had the highest levels of amygdala
activity along with more signs of inflammation in their blood and the
walls of their arteries.
"Our results provide a unique insight
into how stress may lead to cardiovascular disease. This raises the
possibility that reducing stress could produce benefits that extend
beyond an improved sense of psychological wellbeing," said lead author
Dr Ahmed Tawakol, Massachusetts General Hospital and Harvard Medical
School, USA. "Eventually, chronic stress could be treated as an
important risk factor for cardiovascular disease, which is routinely
screened for and effectively managed like other major cardiovascular
disease risk factors." [1]
The researchers note that the activity
seen in the amygdala may contribute to heart disease through additional
mechanisms, since the extra white blood cell production and
inflammation in the arteries do not account for the full link. They also
say that more research is needed to confirm that stress causes this
chain of events as the study was relatively small.
Writing in a
linked Comment, Dr Ilze Bot, Leiden Academic Centre for Drug Research,
Leiden University, The Netherlands, said: "In the past decade, more and
more individuals experience psychosocial stress on a daily basis. Heavy
workloads, job insecurity, or living in poverty are circumstances that
can result in chronically increased stress, which in turn can lead to
chronic psychological disorders such as depression." She says that more
research is needed to confirm the mechanism but concludes: "These
clinical data establish a connection between stress and cardiovascular
disease, thus identifying chronic stress as a true risk factor for acute
cardiovascular syndromes, which could, given the increasing number of
individuals with chronic stress, be included in risk assessments of
cardiovascular disease in daily clinical practice."
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